2015-04-28T10:38:05-07:00 2014-12-31 472251777 CHW LLP 7797 N First Street Suite 15 Fresno CA 93720 990 2014-01-01 952671433 Open Door Community Health Centers OPEN 7078268633 670 Ninth Street Suite 203 Arcata CA 95521 James A Bella Jr CFO 7078268633 2015-04-13 1 Jeremy Ware P00642659 5595495400 2015-04-22 2014 2016-02-25 16:41:14Z James Bella 670 Ninth Street Number 203 Arcata CA 95521 46635154 0 X www.opendoorhealth.com X 1971 CA The OPEN DOOR COMMUNITY HEALTH CENTERS exist to provide health care and education to residents of Humboldt and Del Norte Counties and surrounding rural areas. ODCHC operates 9 clinic sites for the residents of Del Norte and Humboldt Counties. 60% of the patients serviced by ODCHD live on less than 100% of the federal poverty level and 90% live on less than 200% of the federal poverty level. ODCHD also provided a mobile dental program to school-aged children in remote locations. In addition, ODCHD commenced services in Willow Creek, providing medical, dental and behavioral health care to that community and surrounding communities in Trinity and Siskiyou Counties. ODCHD provides health care to all patients regardless of the patients inability to pay. 11 11 0 0 0 0 7249433 6600287 31029815 39259510 16002 20166 1160448 755191 39455698 46635154 0 0 24815938 28760858 0 0 12732482 16539171 37548420 45300029 1907278 1335125 24738745 29925316 11331621 15172870 13407124 14752446 X Open Door Community Health Centers (ODCHC) exists to provide primary health care - medical, dental and behavioral - and health care education to the residents of Del Norte and Humboldt Counties, California and surrounding rural areas, ODCHC operates 13 clinics and four mobile clinics. In 2014, ODCHC served 50,815 unique individuals, providing 224,998 provider/patient/encounters. Of its patients, 50% live at or below 100% FPL and, cumulatively, 81% live at or below 200% FPL; 20% are uninsured and 56% rely on some form of public insurance. ODCHC provides health care services to all who seek it regardless of the inability to pay. 1 0 38910620 0 46635154 Open Door Community Health Centers (ODCHC) exists to provide primary health care - medical, dental and behavioral - and health care education to the residents of Del Norte and Humboldt Counties, California and surrounding rural areas, ODCHC operates 13 clinics and four mobile clinics. In 2014, ODCHC served 50,815 unique individuals, providing 224,998 provider/patient/encounters. Of its patients, 50% live at or below 100% FPL and, cumulatively, 81% live at or below 200% FPL; 20% are uninsured and 56% rely on some form of public insurance. ODCHC provides health care services to all who seek it regardless of the inability to pay. 0 0 0 38910620 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X James A Bella Jr 7078268633 670 Ninth Street Number 203 Arcata CA 95521 Sydney Fisher Larson President 2 0 X 0 0 0 Kathleen E Moxon Vice President 2 0 X 0 0 0 Felicia Oldfather Treasurer 2 0 X 0 0 0 Cyn Van Fleet Secretary 2 0 X 0 0 0 Zuretti Goosby Board Member 2 0 X 0 0 0 Elizabeth Murguia Board Member 2 0 X 0 0 0 Jim Pfingstel Board Member 2 0 X 0 0 0 Neal Sanders Board Member 2 0 X 0 0 0 Lindsay Righter Board Member 2 0 X 0 0 0 Connie Stewart Board Member 2 0 X 0 0 0 Alison Talbot Board Member 2 0 X 0 0 0 Cheyenne Spetzler COO 40 0 X 137605 0 0 James A Bella CFO 40 0 X 148204 0 0 Hermann Spetzler CEO 40 0 X 214323 0 0 Willard Hunter Co- Medical Director 40 0 X 200587 0 0 Julie Ohnemus Co-Medical Director 40 0 X 202721 0 0 Carter Wright Dentist 40 0 X 209506 0 0 Norman Bensky Physician 40 0 X 208648 0 0 Gerald Alston Physician 40 0 X 212089 0 0 Tara Vu Physician 40 0 X 225118 0 0 Kelvin Vu Physician 40 0 X 226611 0 0 1985412 0 0 39 0 1 0 DCI Builder 118 Port Kenyon Road Ferndale CA 95536 Building Construction 467372 OCHIN Inc 707 SW Washington Street Suite 1200 Portland OR 97205 Software Support 1101328 Above and Beyond Cleaning Services 1570 McCullen Avenue Eureka CA 95503 Janitorial 331441 Ray Morgan Company 3131 Esplanade Chico CA 95973 Copier 102769 North Coast Cleaning Services Inc PO Box 177 Eureka CA 95502 Cleaning services 116749 5 0 0 0 0 6508796 91491 72774 6600287 Net Patient Service Revenue 621400 39259510 39259510 0 0 0 0 0 0 39259510 20166 0 0 20166 0 0 0 0 0 0 0 0 0 0 0 0 0 Meaningful Use 621400 586500 586500 0 0 168691 168691 0 0 755191 46635154 40014701 0 20166 903442 363309 540133 21921632 18743853 3177779 360000 316296 43704 3831700 3160977 670723 1744084 1457978 286106 920248 905962 14286 35668 15815 19853 66255 2118 64137 2308997 2291145 17852 27994 21441 6553 355034 206794 148240 1493610 1279708 213902 2704836 2224461 480375 208523 102923 105600 426143 399537 26606 1559068 1440670 118398 204939 185618 19321 Medical Supplies 5546949 5353126 193823 0 Bad Debt 1768 0 1768 0 Postage and Shipping 82989 68206 14783 0 Equipment 539368 436290 103078 0 56782 -65607 122389 45300029 38910620 6389409 0 25715 36182 4021789 6194656 885444 1277563 3547545 3890392 545874 625819 168085 383475 28770982 12125808 15544293 16645174 872055 24738745 29925316 2540858 3046150 300382 386047 8490381 10240673 0 0 1500000 11331621 15172870 X 13407124 14752446 0 0 0 0 13407124 14752446 24738745 29925316 1335125 10197 0 0 0 0 X 0 1 X 1 1 1 X 4626633 5569719 11476605 7249433 6600287 35522677 21724704 22436963 26903549 31029815 39259510 141354541 0 0 0 0 0 0 0 0 0 26351337 28006682 38380154 38279248 45859797 176877218 0 0 0 0 0 0 176877218 12783 13602 14356 16002 20166 76909 0 0 12783 13602 14356 16002 20166 76909 0 0 167371 768582 673811 1160448 586500 3356712 26531491 28788866 39068321 39455698 46466463 180310839 0.98096 0.98163 0.00043 0.00045 X Schedule A, Part III, Line 12 Meaningful Use and Other Income. 0 2849684 2849684 0 14284018 4637742 9646276 0 2978145 1212580 1765565 0 8614020 6275486 2338534 0 45115 0 45115 16645174 0 Estimated third party settlements 1500000 1500000 X 46645352 10198 0 0 0 10198 46635154 0 0 0 46635154 45300029 0 0 0 0 0 45300029 0 0 0 45300029 Schedule D, Part X, Line 2 The Center has been recognized by the Internal Revenue Service as a non-profit corporation as described in Sec. 501(c)(3) of the Internal Revenue Code (IRC) and is exempt from federal and state income taxes on related income pursuant to Sec. 501(a) of the IRC and California Revenue and Taxation code Section 23701(d). The tax years of 2010 through 2013 remain open and subject to examination by the appropriate government agencies in the United States and California. X X 0 0 0 0 0 0 0 0 0 Hermann Spetzler CEO 213816 0 507 0 0 0 0 0 0 0 214323 0 0 0 Willard Hunter Co- Medical Director 180650 0 19937 0 0 0 0 0 0 0 200587 0 0 0 Julie Ohnemus Co-Medical Director 186734 0 15987 0 0 0 0 0 0 0 202721 0 0 0 Gerald Alston Physician 152145 0 59944 0 0 0 0 0 0 0 212089 0 0 0 Norman Bensky Physician 163576 0 45072 0 0 0 0 0 0 0 208648 0 0 0 Kelvin Vu Physician 177910 0 48701 0 0 0 0 0 0 0 226611 0 0 0 Tara Vu Physician 133848 0 91270 0 0 0 0 0 0 0 225118 0 0 0 Carter Wright Dentist 174540 0 34966 0 0 0 0 0 0 0 209506 0 0 0 X 12 72744 FMV 0 0 0 0 Form 990, Part III, Line 2 Open Door Community Health Centers expanded into the Eel River Valley offering medical services in Ferndale and Fortuna. Open Door took on these areas in order to provide continuity of care as the existing primary care options for patients has declined. Form 990, Part VI, Section A, Line 2 Hermann and Cheyenne Spetzler are husband and wife. Form 990, Part VI, Section B, Line 11b Working closely with the appropriate management staff, the CFO gathers and presents the data to the CPA preparing the Form 990 and then presents the draft Form 990 to the Finance Committee of the Board of Directors prior to the Board's review and formal acceptance in a monthly meeting. Form 990, Part VI, Section B, Line 12c Personnel Policies require disclosure of any transactions or business situations (involving the employee and immediate family) which may present a conflict of interest by providing financial benefit resulting from that employees relationship with ODCHC. Board members receive no compensation for their services and are required to provide written Conflict of Interest agreements which are reviewed periodically. Form 990, Part VI, Section B, Line 15 The Board of Directors reviews local, state and national independently prepared salary surveys of community health centers periodically. This data is evaluated in aggregate and with consideration for comparable scope of duties, unique rural conditions, and general economic conditions as well as the economic stability and viability of the organization. Form 990, Part VI, Section C, Line 19 Available upon request.